“This is all, ultimately, a litany of madness—the colors of it, the sounds it makes in heavy nights, the chirping of it across the shoulder of the morning.”

Magic realism and mental illness fuel a swirl of disorienting but lyrical prose in this debut novel by a Nigerian–Tamil writer. Much of the story is told by the ọgbanje (an Igbo term for evil spirits) inhabiting Ada’s head: initially we have the first person plural voice of “Smoke” and “Shadow,” who deem “the Ada” a daughter of the python goddess Ala and narrate her growing-up years in Nigeria; later we get a first-person account from Asụghara, who calls herself “a child of trauma” and leads Ada into promiscuity and drinking when she is attending college in Virginia.

The unusual choice of narrators links Freshwater to other notable works of Nigerian literature: a spirit child relates Ben Okri’s Booker Prize-winning 1991 novel, The Famished Road, while Chigozie Obioma’s brand-new novel, An Orchestra of Minorities, is from the perspective of the main character’s chi, or life force. Emezi also contrasts indigenous belief with Christianity through Ada’s troubled relationship with “Yshwa” or “the christ.”

These spirits are parasitic and have their own agenda, yet express fondness for their hostess. “The Ada should have been nothing more than a pawn, a construct of bone and blood and muscle … But we had a loyalty to her, our little container.” So it’s with genuine pity that they document Ada’s many troubles, starting with her mother’s departure for a mental hospital and then for a job in Saudi Arabia, and continuing on through Ada’s cutting, anorexia and sexual abuse by a boyfriend. Late on in the book, Emezi also introduces gender dysphoria that causes Ada to get breast reduction surgery; to me, this felt like one complication too many.

The U.S. cover

From what I can glean from the Acknowledgments, it seems Ada’s life story might mirror Emezi’s own – at the very least, a feeling of being occupied by multiple personalities. It’s a striking book with vivid scenes and imagery, but I wanted more of Ada’s own voice, which only appears in a few brief sections totalling about six pages. The conflation of the abstract and the concrete didn’t quite work for me, and the whole is pretty melodramatic. Although I didn’t enjoy this as much as some other inside-madness tales I’ve read (such as Die, My Love and Everything Here Is Beautiful), I can admire the attempt to convey the reality of mental illness in a creative way.

My rating:

My gut feeling: I’ve only gotten to two of the five novels longlisted for the Prize, so it’s difficult to say what from the fiction is strong enough to make it through to the shortlist. Of the two, though, I think Sight would be more likely to advance than Freshwater.

Do you think this is a novel that you’d like to read?

Longlist strategy:

I’m about one-fifth of the way through Mind on Fire by Arnold Thomas Fanning, which I plan to review in early March.

I’ve also been sent review copies of The Trauma Cleaner by Sarah Krasnostein and My Year of Rest and Relaxation by Ottessa Moshfegh and look forward to reading them, though I might not manage to before the shortlist announcement.

I’ve placed a library hold on Murmur by Will Eaves; if it arrives in time, I’ll try to read it before the shortlist announcement, since it’s fairly short.

Barring these, there are only two remaining books that I haven’t read and don’t have access to: Astroturf and Polio. I’ll only read these if they make the shortlist.

The Wellcome Book Prize shortlist will be announced on Tuesday, March 19th, and the winner will be revealed on Wednesday, May 1st.

The 2019 Wellcome Book Prize longlist was announced on Tuesday. From the prize’s website, you can click on any of these 12 books’ covers, titles or authors to get more information about them.

This year marks the 10th anniversary of the prize. As always, it’s a strong and varied set of nominees, with an overall focus on gender and mental health. Here are some initial thoughts (see also Laura’s thorough rundown of the 12 nominees):

I’m particularly delighted to see Edelstein on the longlist as her book was one of my runners-up from last year and deserves more attention.

I’m not personally a huge fan of the Greengrass or McBee books, but can certainly see why the judges thought them worthy of inclusion.

Though it’s a brilliant memoir, I never would have thought to put Educated on my potential Wellcome list. However, the more I think about it, the more health elements it has: her father’s possible bipolar disorder, her brother’s brain damage, her survivalist family’s rejection of modern medicine, her mother’s career in midwifery and herbalism, and her own mental breakdown at Cambridge.

Books I knew about and was keen to read but hadn’t thought of in conjunction with the prize: The Trauma Cleaner by Sarah Krasnostein and My Year of Rest and Relaxation by Ottessa Moshfegh.

Novels I had heard of but wasn’t necessarily interested in beforehand: Murmur by Will Eaves and Freshwater by Akwaeke Emezi. I went to get Freshwater from the library the afternoon of the longlist announcement and am now 60 pages in. I’d be tempted to call it this year’s Stay with Me except that the magic realist elements are much stronger here, reminding me of what I know of work by Chigozie Obioma and Ben Okri. The novel is narrated in the first person plural by a pair of (gods? demons? spirits?) inhabiting Ada’s head.

And lastly, there are a few books I had never even heard of: Polio: The Odyssey of Eradication by Thomas Abraham, Mind on Fire: A Memoir of Madness and Recovery by Arnold Thomas Fanning, and Astroturf by Matthew Sperling. I’m keen on the Fanning but not so much on the other two. Polio will likely make it to the shortlist as this year’s answer to The Vaccine Race; if it does, I’ll read it then.

Some statistics on this year’s longlist, courtesy of a press release sent by Midas PR:

Five novels (two more than last year – I think we can see the influence of novelist Elif Shafak), five memoirs, one biography, and one further nonfiction title

Most of the authors are British or American, while Fanning is Irish (Emezi is Nigerian-American, Jauhar is Indian-American, and Krasnostein is Australian-American).

Chair of judges Elif Shafak writes: “In a world that remains sadly divided into echo chambers and mental ghettoes, this prize is unique in its ability to connect various disciplines: medicine, health, literature, art and science. Reading and discussing at length all the books on our list has been fascinating from the very start. We now have a wonderful longlist, of which we are all very proud. Although it sure won’t be easy to choose the shortlist, and then, finally, the winner, I am thrilled about and truly grateful for this fascinating journey through stories, ideas, ground-breaking research and revolutionary knowledge.”

We of the shadow panel have divided up the longlist titles between us as follows (though we may well each get hold of and read more of the books, simply out of personal interest) and will post reviews on our blogs within the next five weeks.

Amateur: A true story about what makes a man by Thomas Page McBee – LAURA

Astroturf by Matthew Sperling – PAUL

Educated by Tara Westover – CLARE

Freshwater by Akwaeke Emezi – REBECCA

Heart: A history by Sandeep Jauhar – LAURA

Mind on Fire: A memoir of madness and recovery by Arnold Thomas Fanning – REBECCA

Murmur by Will Eaves – PAUL

My Year of Rest and Relaxation by Ottessa Moshfegh – CLARE

Polio: The odyssey of eradication by Thomas Abraham – ANNABEL

[Sight by Jessie Greengrass – 4 of us have read this; I’ll post a composite of our thoughts]

The Trauma Cleaner: One woman’s extraordinary life in death, decay and disaster by Sarah Krasnostein – ANNABEL

This Really Isn’t About You by Jean Hannah Edelstein – LAURA

The Wellcome Book Prize shortlist will be announced on Tuesday, March 19th, and the winner will be revealed on Wednesday, May 1st.

Nancy Tucker’s first book, The Time in Between (2015), was a wrenching and utterly absorbing eating disorder memoir told in an original blend of forms: cinematic scenes of dialogue and stage directions, schedules, tongue-in-cheek dos and don’ts, imagined interrogations, and so on. She’s recreated that experimental/hybrid style here to capture the experiences of young women with mental health challenges.

At a time when she was still struggling with anorexia and suicidal thoughts, bouncing between her uni room and a psychiatric ward, Tucker felt the need to get beyond her own pain by engaging with others’ problems. She interviewed 70 women aged 16 to 25 for a total of more than 100 hours and chose to anonymize their stories by creating seven composite characters who represent various mental illnesses: depression, bipolar disorder, self-harm, anxiety, eating disorders, PTSD and borderline personality disorder.

Each chapter follows a similar format, focusing on a first-person narrative from the invented character but also interspersing other documents like e-mails, instant messages, conversations with a therapist, a video interview transcript or a self-interrogation. A different font then sets out a few-page section that, in a sardonic tone, suggests the problem really isn’t that serious and is easily solved with a handful of simple tips. After this point Tucker steps out of character to give statistics and commentary on the particular mental illness, as she heard it described by her interviewees. She returns to the character’s voice to close with a “What I wish I could tell you about my [depression, etc.]” section, a heartfelt plea for sympathy.

These stories overlap with each other – anxiety and depression commonly co-occur with other mental illness, for instance. Yasmine’s bipolar means that sometimes she feels like she could run a marathon or write a novel in a few days, while other times she’s plunged into the depths of depression. Neither Abby (depression) nor Freya (anxiety) can face going to work; Maya (BPD, also known as emotionally unstable personality disorder) exhibits many of the symptoms from other chapters, including self-harm and feelings of emptiness.

Tucker is keen to emphasize how complex these disorders are: it’s never just a matter of being sad, having mood swings or seeking attention. She is sensitive to the way that certain ones might be belittled, such as binge eating disorder, which, because it isn’t as clinically recognized as anorexia or bulimia, can be equated with poor self-control. Also, mental health conditions exist on a continuum, so it’s hard to definitively announce a cure. In any case, “A binary perception of mental illness benefits no one,” Tucker explains: “the ‘insane’ may find themselves held at arms’ length, but the ‘sane’ may be denied rapid treatment, or accused of melodrama.”

The details of these narratives can be painful to read, like Georgia and friends browsing Tumblr for ideas of how to cut themselves with razors and take not-quite-overdoses of paracetamol, and Holly’s post-traumatic stress after not-quite-consensual sex with her boyfriend. But the voices are so intimately rendered, and the chapters so perfectly balanced between the general and the fictionalized particulars, that they illuminate mental health crises in a uniquely powerful way.

Reading this has helped me to understand friends’ and acquaintances’ behavior. I’ll keep it on the shelf as an invaluable reference book in the years to come. Based on what I’ve read thus far, this is my frontrunner for next year’s Wellcome Book Prize, which “aims to excite public interest and encourage debate around [medical] topics.” That Was When People Started to Worry seems to me to be just what the prize is looking for, as “Books that find stories in those brushes with medicine are ones that add new meaning to what it means to be human.”

My rating:

That Was When People Started to Worry: Windows into Unwell Minds was published by Icon Books in May. My thanks to the publisher for a free copy for review.